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Gene Abnormalities Predict Future Cancer Risk

CancerWise - August 2007

Survivors of Hodgkin's lymphoma who have greater genetic instability in their white blood cells are found to be 2½ times more likely to develop another type of cancer, according to results of a new study.

Significance of results

M. D. Anderson researchers who conducted the study say the presence of certain chromosomal (a compact form of the genetic material or DNA) abnormalities potentially could be used to predict whether survivors of Hodgkin's or other types of cancer are at high risk of developing second primary tumors.

"We can use this measure of genetic instability to identify patients at high risk and counsel them to continue regular screening for breast, colon, lung and other cancers even after their Hodgkin's lymphoma has disappeared," says principal investigator Randa El-Zein, M.D., Ph.D., an associate professor in M. D. Anderson's Department of Epidemiology.

"We also can emphasize that they should especially avoid tobacco use or exposure to environmental toxins at work and eat a healthy diet. We can tell them, 'You're at risk, don't do anything to make it worse,'" she says.

Research methods

The research team reviewed the medical records of 252 adults treated for Hodgkin's lymphoma at MD Anderson between 1986 and 1992. The patients had cytogenetic analysis (a close examination of the chromosomes in their lymphocytes, a type of white blood cell that helps fight infection) before and periodically during treatment.

After closely examining each patient's analysis, researchers measured chromosomal damage per 100 cells.

Primary results

The median follow-up period was 13 years.

During that time, 27 patients developed cancers, including:

  • Five solid tumors
  • Four leukemias
  • 11 skin cancers
  • Seven lymphomas

"We found that people with a higher level of chromosomal aberrations are the ones who developed second primary tumors," El-Zein says.

Researchers evaluated the average chromosome damage per 100 cells. Those with higher chromosomal breaks were 2.48 to 2.78 times more likely to develop new cancers.

Researchers then evaluated the average chromosome breaks per 100 cells.

They found that patients who developed a second primary cancer had a higher level of breaks than those who did not develop a second primary cancer (5.91 breaks versus 3.97 breaks, respectively.)

Additional results

Although this survey looked only at Hodgkin's lymphoma, researchers believe it may be valid in other types of cancer as well.

"Whatever can be applied to Hodgkin's can be applied to other cancers, so chromosomal screening has potentially broad application for gauging second primary cancer risk across types of cancer," El-Zein says.

Background

"Hodgkin's lymphoma is a highly treatable cancer of the lymphatic system, and many patients do very well," El-Zein says. "However, some patients are at risk of developing another type of cancer later, for example solid tumors, leukemia or melanoma, but we cannot identify those patients in advance now."

What's next?

The research team is continuing analysis of chromosomal damage in Hodgkin's lymphoma to search for correlations to a patient's response to treatment.

– From staff reports

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© 2014 The University of Texas MD Anderson Cancer Center